Implantation of Hemipelvic Prosthesis After Resection of Sarcoma

Constrained Total Hip Megaprosthesis for Primary Periacetabular Tumors

“…Dislocation and aseptic loosening of endoprostheses are other major postoperative complications. The rates of dislocation (16%) and aseptic loosening (8%) in the present series were also comparable to other reported series: 2.5% to 17% for dislocation [1,11,14,24,27,[36][37][38]] and 3.7% to 25% for aseptic loosening of implants [11,14,21,27,38]. Four patients sustained dislocations caused by violent falls despite the use of a constrained joint mechanism, three of whom also had concomitant deep infection.…”

“…hemipelvic prostheses [1,18,27,36,37], 11% to 24% in modular-type hemipelvic prostheses [11,14,24,38], and 8% to 60% in allograft reconstruction [2,22,23,26,39]. To reduce the risk of postoperative deep infection, we need to adopt intraoperative repeated and meticulous ultrasonic irrigation, routine use of antibiotic-loading bone cement, application of muscle/or musculocutaneous flap, and twostaged reconstruction after tumor resection followed by a ''Reconstruction cup'' (C-THA) endoprosthesis 55% (30%-80%) 32%…”

“…However, limb-salvage reconstruction of malignant pelvic tumors, especially in the periacetabular region, remains challenging because of the complex anatomy, the difficulty achieving wide surgical margins, and large bone and soft tissue defects after tumor resection. The reconstructive options include resection arthroplasty [7,30,33], iliofemoral or ischiofemoral arthrodesis [9,12], hip transposition method (pseudarthrosis) [3,12,32], free-vascularized fibular graft for pelvic ring reconstruction [29], allograft [2,22,23,26,39], recycled autologous bone graft [16,20], and endoprosthetic replacement [1,4,11,14,18,21,24,25,27,28,34,[36][37][38]. However, no standard reconstructive procedure exists after internal hemipelvectomy for malignant periacetabular tumors.…”

Two-staged revision with custom made prosthesis in septic failure of massive allograft reconstruction after type II-III pelvic resection

“…Also, pelvic prostheses are associated with primary stability problems, high rates of loosening in longterm and high dislocation rates (3.5 to 20%). [7,9,10] Until now, we did not observe these problems. To decrease the potential for aseptic loosening, we had the implant coated with hydroxyapatite where bone contact was expected.…”

“…Five-year survival of similar implants was reported as 42 to 76% in the literature. [7,9,10] In two-year follow-up, our patient is symptom free. He is able to walk without any external support and has a good functional outcome.…”